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Updated: Jan 25, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Variation in femoral anteversion in patients requiring total hip replacement
Jim W Pierrepont1,2, Ed Marel3, Jonathan V Baré4
1School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Australia.
Background:
Optimal implant alignment is important for total hip replacement (THR) longevity. Femoral stem anteversion is influenced by the native femoral anteversion. Knowing a patient's femoral morphology is therefore important when planning optimal THR alignment. We investigated variation in femoral anteversion across a patient population requiring THR.
Methods:
Preoperatively, native femoral neck anteversion was measured from 3-dimensional CT reconstructions in 1215 patients.
Results:
The median femoral anteversion was 14.4° (-27.1-54.5°, IQR 7.4-20.9°). There were significant gender differences (males 12.7°, females 16.0°; p < 0.0001). Femoral anteversion in males decreased significantly with increasing age. 14% of patients had extreme anteversion (<0° or >30°).
Conclusions:
This is the largest series investigating native femoral anteversion in a THR population. Patient variation was large and was similar to published findings of a non-THR population. Gender and age-related differences were observed. Native femoral anteversion is patient-specific and should be considered when planning THR.
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